Zhu H Y, Wang L, Qiao J, Zou Y X, Xia Y, Wu W, Cao L, Liang J H, Fan L, Xu W, Li J Y
Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 May 14;39(5):392-397. doi: 10.3760/cma.j.issn.0253-2727.2018.05.009.
To validate the prognostic value of chronic lymphocytic leukemia-international prognostic index (CLL-IPI) for Chinese CLL patients. Two hundred and fifteen CLL patients who were initially diagnosed and treated in Jiangsu Province Hospital from January 2002 to November 2017 were included in the retrospective analysis. Risk stratification and prognosis were evaluated by CLL-IPI scoring system. ①Of the 215 patients, 143 were males and 72 were females, with a median age of 60 (16-85) years old. The median treatment-free survival (TFS) and overall survival (OS) was 16 months (4-24 months) and 180 months (145-215 months), respectively. ② The median TFS for low (=60), intermediate (=50), high (=45) and very high risk group (=60) according to the CLL-IPI scoring system was 56, 15, 12 and 5 months, respectively (<0.001). ③ The median follow-up was 48 months (1-192 months). The median OS for low risk group was not reached and for intermediate, high, and very high risk group was 180, 89 and 74 months, respectively. The estimated 5-year OS rate was 97.6%, 83.7%, 67.8% and 55.2%, respectively (<0.001). ④ Multivariate analysis indicated that unmutated immunoglobulin heavy chain variable region (IGHV) gene and β(2)-microglobulin>3.5 mg/L(<0.001) were independent prognostic factors of TFS, while TP53 deletion and/or mutation(=0.008), unmutated IGHV (=0.017) and age>65 years(=0.045) were independent prognostic factors of OS. CLL-IPI is the powerful tool for risk stratification in Chinese CLL patients.
验证慢性淋巴细胞白血病国际预后指数(CLL-IPI)对中国慢性淋巴细胞白血病(CLL)患者的预后价值。对2002年1月至2017年11月在江苏省人民医院首次诊断并接受治疗的215例CLL患者进行回顾性分析。采用CLL-IPI评分系统评估风险分层和预后。①215例患者中,男性143例,女性72例,中位年龄60(16 - 85)岁。中位无治疗生存期(TFS)和总生存期(OS)分别为16个月(4 - 24个月)和180个月(145 - 215个月)。②根据CLL-IPI评分系统,低危(=60)、中危(=50)、高危(=45)和极高危组(=60)的中位TFS分别为56、15、12和5个月(<0.001)。③中位随访时间为48个月(1 - 192个月)。低危组的中位OS未达到,中危、高危和极高危组的中位OS分别为180、89和74个月。估计5年OS率分别为97.6%、83.7%、67.8%和55.2%(<0.001)。④多因素分析表明,免疫球蛋白重链可变区(IGHV)基因未突变和β2微球蛋白>3.5 mg/L(<0.001)是TFS的独立预后因素,而TP53缺失和/或突变(=0.008)、IGHV未突变(=0.017)和年龄>65岁(=0.045)是OS的独立预后因素。CLL-IPI是中国CLL患者进行风险分层的有力工具。